Shingles and PHN, a new, bimonthly open access peer-reviewed journal, will be launched in fall 2011 by Mary Ann Liebert, Inc., publishers (www.liebertpub.com). It will provide a much-needed authoritative source and central forum on research and clinical applications. There are over 1 million new cases of shingles each year in the United States alone. An outbreak of shingles is often followed by a disabling condition known as postherpetic neuralgia (PHN), which is difficult to treat and can have serious consequences.
More than 1 in 3 people in the U.S. will develop shingles in their lifetime. Shingles is a painful skin rash caused by the varicella zoster virus, the same virus that causes chickenpox. Anyone who has recovered from chickenpox may develop shingles; however, the risk of getting the disease increases as a person gets older-about half of all cases occur among men and women who are over 60, and in patients who are immunocompromised, such as cancer patients, people taking immunosuppressive medications, and those with HIV. Herpes zoster should not be confused with herpes simplex which can be a sexually transmitted disease.
Postherpetic neuralgia, a complication of shingles, affects 1 in 5 individuals. PHN is pain that continues for longer than 90 days after the appearance of the shingles rash. The pain associated with postherpetic neuralgia can be intense burning, stabbing, or jolting pain that may last for months or even years.
Last week, the FDA updated its approval for the Merck shingles vaccine, Zostavax, expanding the eligibility from immune-competent adults aged 60 and older to include immune-competent individuals aged 50-59. This will provide a broad window of opportunity for immunization prior to the complications of Medicare Part D funding, but will further stress the shortage of the vaccine.
The new Journal is under the editorial leadership of Barbara P. Yawn, MD, MSc, FAAFP, Director of Research, Olmsted Medical Center, and Adjunct Professor, Family and Community Health, University of Minnesota. Dr. Yawn's research has provided some of the largest group of community-based shingles cases for which diagnosis has been confirmed by medical record review, and shingles complications have been explored. Her work has confirmed the decades-long increase in shingles in all age groups. Most recently, she presented data to challenge virologists and others to explain the significant rates of shingles recurrence in adults, often beginning within one to three years of the initial presentation of the disease.
Working with colleagues at the CDC, Dr. Yawn is currently studying the early burden of shingles and exploring factors associated with reactivation of the virus that results in shingles episodes. "This new journal will provide an opportunity for scientists, researchers, clinicians, and patients to work beyond the silos of their own disciplines to understand this virus and its disease-causing potential-translational research that goes from bench to the community and completes the circle asking more clinically based questions and providing information to guide the basic scientists," says Dr. Yawn.
"Shingles is common, painful, expensive, and too often leads to chronic pain," continues Editor-in-Chief Yawn. "We don't know what causes it. Prevention is possible, but the shingles vaccine is not widely given, and physicans' awareness must be heightened. Attention in the medical literature is disjointed, with few cross-disciplinary collaborations. A journal dedicated to shingles and postherpetic neuralgia will focus attention on the important issues and facilitate the collaborations that will be required to address this disabling condition."
The Journal will explore all aspects of shingles and PHN, including studies of the virus; what causes the virus to reactivate; its actions on the human body; effective pharmacologic and nonpharmacologic acute treatment of shingles and long-term management of PHN; benefits and contraindications of the shingles vaccine; and implications for insurers and policymakers. Shingles and PHN will include a broad range of scientific research and clinical studies with an impact across many fields including virology, epidemiology, infectious disease, neurology, dermatology, primary care, and policymakers to address this common and disabling condition.
"Clinicians' options for treating shingles and postherpetic neuralgia are limited and often ineffective," says Mary Ann Liebert, president of Mary Ann Liebert, Inc. "There is a strong imperative for a dedicated multidisciplinary forum to ensure that research advances and clinical recommendations are well disseminated, and for the herpes zoster virus, postherpetic neuralgia, and the shingles vaccine to be well understood."